The Only SLP in the Country Left “Months Ago…”

Today I delivered the last of three presentations to 70 professionals from Bhutan. Most were “Physiotechs” or Physical Therapists, Special Educators, and a few Ministers and hospital doctors (pediatrics, psychiatry). Many people commented afterward how much they appreciated the videotapes of clinic clients in therapy sessions, so thanks to SPG clinic staff and clients’ families who contributed to these efforts. We asked the audience about what they learned which was most surprising, and some of the comments were that they didn’t realize that therapy with children would be play-based and that parent training would be so important. Dr Berman and I also role played administering the PLS, with Dr. Berman taking the role of a “difficult to test, three-year-old child with ADHD and language issues,” with the audience clearly enjoying his antics and my efforts to contain him and get him to cooperate.

The visit to the local hospital was an eye-opener. I spoke with Dr. Philip, a US pediatrician on a two year contract, and he has as many as 28 patients with acute illness whom he cares for on a daily basis. He is on a rotating weekly on-call status 24/7, so in emergencies, has to get to the hospital at any given hour. His rounds are pretty much non-stop, 9am-3pm. Given the terrain is so mountainous and thus it is difficult to travel to the capital city’s hospital, most kids are in severe distress when they arrive.

I also met the hospital’s only audiologist. He was trained in India and has both speech and audiology degrees, but he described minimal duties as a speech pathologist. Once diagnosed with hearing impairment, children do have access to some hearing aids. There are no children fitted with cochlear implants at this time (in fact, he laughed when I asked this question)! He did have access to a sound-proof booth, also had an “audio tech assistant”, and told me his training in India took 5 years to complete. Next door to his suite was an office titled “speech therapist” but there was no one there providing ANY speech therapy given the country’s one and only therapist left several months ago.

Next week we will be doing multidisciplinary consults at the hospital Monday-Thursday. We will also be meeting with our sponsors, Ability Bhutan Society, to discuss ways in which we could be most helpful in future efforts. Finally, we will be touring the capital city’s Special Education School, and meeting with the Director there, Madam Chimi. We will also tour the school for the deaf in Paro. There are currently efforts with Unicef spear-heading efforts to provide Early Intervention Centers in key areas of the country. Dr. Berman and his wife, Shiva, are trying to ascertain how future missions could help support these efforts with respect to fund-raising efforts back at home in the US.